Module 2, Session 1
Meningitis In-Class Case Study
Peter is a 19-year-old male with a history of a liver transplant due to Hepatitis B contracted after a blood
transfusion as an infant. He recently returned from his first year living in a college dorm and arrives to the
Emergency Department (ED) with complaints of a severe headache, photophobia, and vomiting. His VS are
as follows: 136/82, HR 106, RR 20, O2 sat 96%, Temp 38.2 C (100.8 F). He states, “This is the worse headache
I’ve ever had in my life.”
Group 1:
The ER Tech has taken Peter into a room and the nurse enters. What additional symptoms should
the nurse ask Peter about?
Fever
Neck stiffness (nuchal rigidity)
Weakness/numbness
Disorientation/memory impairment
Recent injury
Rash (occurs with Nisseria Meningitidis)
LOC
Seizures
History of headaches
Group 2:
1. What physical assessments should the nurse perform?
2. For your neurological assessment:
a. What are your priorities?
b. How would your approach and technique differ from an assessment done on another
patient with altered mental status?
Neuro assessment- how would your priorities, approach, and technique differ from an assessment
done on an patient with altered MS?
Kernig’s Sign (patient lies flat with leg flexed; cannot fully extend if meningitis)
Brudzinski’s Sign (when neck is flexed, lower extremities automatically flex)
Group 3:
Considering patient-centered care, what nursing interventions can/should the nurse implement
prior to receiving orders from the health care provider?
Quiet Room
Private Room
Infection Control Precautions (suspect meningitis)… oral and nasal discharge is considered infectious
Protect from injury due to altered LOC
Group 4:
1. What illness does the nurse suspect that Peter may have?
2. What risk factors does he have that make this a possibility?
Meningitis
RF: communal living, altered immunity
Group 5:
The health care provider will be coming in to see Peter soon. What collaborative care should the
nurse anticipate in order to expedite Peter’s medical diagnosis and care?
Meningitis In-Class Case Study
Peter is a 19-year-old male with a history of a liver transplant due to Hepatitis B contracted after a blood
transfusion as an infant. He recently returned from his first year living in a college dorm and arrives to the
Emergency Department (ED) with complaints of a severe headache, photophobia, and vomiting. His VS are
as follows: 136/82, HR 106, RR 20, O2 sat 96%, Temp 38.2 C (100.8 F). He states, “This is the worse headache
I’ve ever had in my life.”
Group 1:
The ER Tech has taken Peter into a room and the nurse enters. What additional symptoms should
the nurse ask Peter about?
Fever
Neck stiffness (nuchal rigidity)
Weakness/numbness
Disorientation/memory impairment
Recent injury
Rash (occurs with Nisseria Meningitidis)
LOC
Seizures
History of headaches
Group 2:
1. What physical assessments should the nurse perform?
2. For your neurological assessment:
a. What are your priorities?
b. How would your approach and technique differ from an assessment done on another
patient with altered mental status?
Neuro assessment- how would your priorities, approach, and technique differ from an assessment
done on an patient with altered MS?
Kernig’s Sign (patient lies flat with leg flexed; cannot fully extend if meningitis)
Brudzinski’s Sign (when neck is flexed, lower extremities automatically flex)
Group 3:
Considering patient-centered care, what nursing interventions can/should the nurse implement
prior to receiving orders from the health care provider?
Quiet Room
Private Room
Infection Control Precautions (suspect meningitis)… oral and nasal discharge is considered infectious
Protect from injury due to altered LOC
Group 4:
1. What illness does the nurse suspect that Peter may have?
2. What risk factors does he have that make this a possibility?
Meningitis
RF: communal living, altered immunity
Group 5:
The health care provider will be coming in to see Peter soon. What collaborative care should the
nurse anticipate in order to expedite Peter’s medical diagnosis and care?
